Members Reinstatement Form | The Explorers Club

REQUEST & Information

Take a moment to review the instructions and policies at the back of this form. Please provide all requested information completely and succinctly. We are not responsible, nor do we return, any unsolicited materials included for committee review. N.B. as of 11/08/2015 there is a $100.00 processing fee for reinstatements.

Mark Current Status(Required)

Resigned

Dropped

Current Designation(Required)

Sponsor(Required)

Co-Sponsor(Required)

Chapter(Required)

Contact Information

Prefix or Title

First Name(Required)

Middle Name

Last Name(Required)

Suffix

Job Title

Company or Institution

Address(Required)

City(Required)

Postal Code(Required)

State or Province(Required)

Country(Required)

Member Number

Home Telephone

Work Telephone

Mobile Telephone(Required)

Fax

Email Address(Required)

Other Email Address

Personal URL or Website

Personal Profile

Date of Birth(Required)

Place of Birth(Required)

Country of Citizenship(Required)

Gender(Required)

Present Occupation

Title

Company or Institution

Department or Division

Previous Occupation

Title

Company or Institution

Department or Division

UPDATE YOUR EXPLORATION PROFILE

For the following use the spaces provided and add pages as necessary

1. In which year and under what circumstances did you leave the Club?(Required)

2. Why do you wish to rejoin the Club?(Required)

3. Since you left, to which additional scientific or cultural institutions do you belong?(Required)

4. Since you left, have you added to your exploration interests?(Required)

5. Since you left, list additions to honors, awards and special recognition related to exploration.(Required)

6. Since you left, list additions to presentations, lectures, and seminars that you have presented related to exploration.(Required)

7. Since you left, list additions to your bibliography – books, articles and papers that you have authored – related to exploration.(Required)

UPDATE YOUR EXPLORATION RÉSUMÉ

Summarize your expedition and research field work experiences, both vocational and avocational. Add extra pages as required to present your accomplishments and contributions to exploration. For each separate endeavor, include dates, objectives, sponsoring institutions, if any, your specific role, the results, and how the results were utilized and distributed.

File(Required)

Drop files here or

Max. file size: 256 MB.

Full Name of Applicant(Required)

Date(Required)

INSTRUCTIONS AND POLICIES

When preparing your request for reinstatement, remember that neatness counts. If you are writing the request by hand, please be legible. If you are entering information into the Word or PDF document, please honor the formatting. If you are adding pages to supplement the Word or PDF document, please label them. When a reviewer has to wrestle with a hard-to-read application, the applicant gets less attention than deserved.

Qualifying for Reinstatement

For reinstatement to the Club you are expected to satisfy the fundamental qualifications for membership, that you are someone of good reputation and of excellent moral and ethical standards.

How a Reinstatement Request is Processed

The Membership Committee reviews your request to determine whether you are eligible for reinstatement. If you are not, you are notified by letter. If you are, the committee places your name on the approval list for the next meeting of the Board of Directors. Once the Board approves, you are notified by letter.

Fees

Members who have been readmitted through the Club’s Reinstatement Process will be charged a $100.00 administrative fee. Those approved for reinstatement are responsible for paying the current years dues. Membership will not be activated until both these charges are settled.

Questions

For more information about membership, forms, fees, and the Club in general please visit our website, www.explorers.org.

Untitled(Required)

I'lI confirm that the form has been verified and filled out with the real data

Reinstatement of Member

Reinstatement of Member

REQUEST & Information

Contact Information

Personal Profile

UPDATE YOUR EXPLORATION PROFILE

UPDATE YOUR EXPLORATION RÉSUMÉ

INSTRUCTIONS AND POLICIES

Qualifying for Reinstatement

How a Reinstatement Request is Processed

Fees

Questions